+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Role of the Renin-Angiotensin-Aldosterone System and Its Pharmacological Inhibitors in Cardiovascular Diseases: Complex and Critical Issues



Role of the Renin-Angiotensin-Aldosterone System and Its Pharmacological Inhibitors in Cardiovascular Diseases: Complex and Critical Issues



High Blood Pressure and Cardiovascular Prevention 22(4): 429-444



Hypertension is one of the major risk factor able to promote development and progression of several cardiovascular diseases, including left ventricular hypertrophy and dysfunction, myocardial infarction, stroke, and congestive heart failure. Also, it is one of the major driven of high cardiovascular risk profile in patients with metabolic complications, including obesity, metabolic syndrome and diabetes, as well as in those with renal disease. Thus, effective control of hypertension is a key factor for any preventing strategy aimed at reducing the burden of hypertension-related cardiovascular diseases in the clinical practice. Among various regulatory and contra-regulatory systems involved in the pathogenesis of cardiovascular and renal diseases, renin-angiotensin system (RAS) plays a major role. However, despite the identification of renin and the availability of various assays for measuring its plasma activity, the specific pathophysiological role of RAS has not yet fully characterized. In the last years, however, several notions on the RAS have been improved by the results of large, randomized clinical trials, performed in different clinical settings and in different populations treated with RAS inhibiting drugs, including angiotensin converting enzyme (ACE) inhibitors and antagonists of the AT1 receptor for angiotensin II (ARBs). These findings suggest that the RAS should be considered to have a central role in the pathogenesis of different cardiovascular diseases, for both therapeutic and preventive purposes, without having to measure its level of activation in each patient. The present document will discuss the most critical issues of the pathogenesis of different cardiovascular diseases with a specific focus on RAS blocking agents, including ACE inhibitors and ARBs, in the light of the most recent evidence supporting the use of these drugs in the clinical management of hypertension and hypertension-related cardiovascular diseases.

(PDF emailed within 0-6 h: $19.90)

Accession: 058791184

Download citation: RISBibTeXText

PMID: 26403596

DOI: 10.1007/s40292-015-0120-5


Related references

Effectively targetting the renin-angiotensin-aldosterone system in cardiovascular and renal disease: rationale for using angiotensin II receptor blockers in combination with angiotensin-converting enzyme inhibitors. Journal of the Renin-Angiotensin-Aldosterone System 1(3): 217-233, 2002

Dynamic Changes in the Renin-Angiotensin-Aldosterone System and the Beneficial Effects of Renin-Angiotensin-Aldosterone Inhibitors on Spatial Learning and Memory in a Rat Model of Chronic Cerebral Ischemia. Frontiers in Neuroscience 11: 359, 2017

The importance of studying the renin-angiotensin-aldosterone system in essential arterial hypertension in clinical practice. Activity of the renin-angiotensin-aldosterone system during treatment of hypertension with ACE-inhibitors and beta blockers. Vnitrni Lekarstvi 40(9): 557-562, 1994

Renin-angiotensin-aldosterone system blockade in diabetes: role of direct renin inhibitors. Postgraduate Medicine 121(3): 33-44, 2009

New perspectives in the renin-angiotensin-aldosterone system (RAAS) III: endogenous inhibition of angiotensin converting enzyme (ACE) provides protection against cardiovascular diseases. Plos One 9(4): E93719, 2015

Urinary renin, but not angiotensinogen or aldosterone, reflects the renal renin-angiotensin-aldosterone system activity and the efficacy of renin-angiotensin-aldosterone system blockade in the kidney. Journal of Hypertension 29(11): 2147-2155, 2012

The activity of renin-angiotensin-aldosterone system (RAA) and possibilities of application angiotensin converting enzyme inhibitors (ACE I) in selected diseases of endocrine glands. Wiadomosci Lekarskie 52(3-4): 202-210, 1999

Renin-angiotensin-aldosterone system inhibition: overview of the therapeutic use of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, mineralocorticoid receptor antagonists, and direct renin inhibitors. Primary Care 41(4): 765-778, 2015

The effects of angiotensin converting enzyme inhibitors and the role of the renin-angiotensin-aldosterone system in J-2-N cardiomyopathic hamsters. Japanese Circulation Journal 56(1): 46-51, 1992

Genotypes of the renin-angiotensin-aldosterone system: on the search of cardiovascular diseases. Revista Espanola de Cardiologia 55(2): 89-91, 2002

Pathophysiologic mechanisms of the renin-angiotensin-system and the pharmacological influence of ACE-inhibitors or angiotensin II-type 1-receptor antagonists in cardiovascular disease. Zeitschrift fuer Kardiologie 86(4): 239-250, 1997

Renin-angiotensin-aldosterone system and natriuretic peptide system--reference to cardiovascular diseases. Nihon Rinsho. Japanese Journal of Clinical Medicine 62 Suppl 9: 164-169, 2004

Renin-angiotensin-aldosterone system blockade for cardiovascular diseases: current status. British Journal of Pharmacology 160(6): 1273-1292, 2010

Blockers of the renin-angiotensin-aldosterone system: almost, but not yet, an absolute weapon against cardiovascular and renal diseases!. Journal of the Renin-Angiotensin-Aldosterone System 13(1): 216, 2012

The role of the renin--angiotensin--aldosterone system in cardiovascular homeostasis in normal man. Clinical Science and Molecular Medicine. Supplement 2: 49s-52s, 1975